EXPERIENCE OF TREATMENT with ANTI-PD-1: FROM WORLD STANDARDS TO REAL CLINICAL PRACTICE (CLINICAL OBSERVATION)

Background. Every fourth patient with a newly diagnosed skin melanoma has metastatic or locally advanced inoperable stage of this tumor, which determines an unfavorable prognosis of the course of the disease. This article presents the experience of SPBSBHCI CCOD in the treatment of metastatic melanoma in adult patients with an evaluation of the effectiveness of nivolumab, the PD-1 inhibitor. Methods. Twelve patients with disseminated skin melanoma who received treatment at the St. Petersburg City Clinical Oncological Dispensary from 2002 to the present day were under observation. The time from the moment of diagnosing the IV stage of the disease to the initiation of nivolumab therapy ranged from 4 to 31 months. Results. By the present moment of time (May 2018) only 3 out of 12 patients (25%) have recorded progression of the process. At the stage of this analysis, the mean time without progression is 25.75±3.13 months (95% CI, 19.61-31.89), 10 out of 12 patients (83.33%) are alive. Now, the average overall survival rate is 28.27±2.49 months (95% CI, 23.30-33.03). A clinical example of female patient with metastatic melanomA., including brain lesions, treated with nivolumab is presented. The overall survival of the patient from the moment of diagnosing the 4th stage of the disease was 3.5 years, of which, 2.5 years with nivolumab therapy. At the momenT., the patient’s condition is stable clinically and according to the results of objective examination methods. Conclusion. The provided data confirm the high efficiency of the use of immune-oncological drugs, such as the PD-1 blocker nivolumab, in the treatment of metastatic melanoma. It is important to note that the use of nivolumab in addition to achieving an objective response allows to keep the effect achieved for a long time.

PD-1, metastatic melanoma, immune checkpoint inhibitor blockers, immunotherapy, PD-1, nivolumab